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TMA Wants 'Meaningful Use' Meaningful

The Texas Medical Association agrees in principle with the federal government's attempt to define "meaningful use" of electronic medical records (EMRs), especially with how it moves "from 'pay-for-reporting' in 2011 to 'pay-for-doing' in 2013 and then 'pay-for-improving outcomes' in 2015."

That is the among the comments TMA made in a June 26 letter [ PDF ] to David Blumenthal, MD, national coordinator for health information technology with the U.S. Department of Health and Human Services.

President Obama's economic stimulus package authorizes the Centers for Medicare & Medicaid Services (CMS) to provide financial incentives for eligible physicians who "meaningfully use" EMRs. The payments begin in 2011 for eligible Medicare physicians; physicians who have not demonstrated they are meaningful users of an EMR by 2015 will face reductions in their Medicare payments, which start at 1 percent.

"There needs to be a process outlined that describes how these measures will be vetted once they are determined and/or more refined," TMA President William H. Fleming III, MD, and Joseph Schneider, MD, MBA, chair of TMA's Ad Hoc Committee on Health Information Technology, said in the letter. "TMA wants to ensure there is sufficient representation from the clinicians directly caring for patients. As meaningful use definitions are more clearly defined, there should also be a strong emphasis on physician workflow and administrative simplification."

Earlier, TMA, the American Medical Association, and dozens of other physician organizations told federal officials they generally support what the government is trying to do, but they have some reservations.

The groups said in a letter to Dr. Blumenthal that they are concerned the government's timeline "is too aggressive, given that we continue to lack the necessary infrastructure, standards, and systems." They added that they have "significant concerns" about the government's proposed rules covering appropriate access to and exchange and reporting of health care data; costs associated with disseminating the information; privacy measures, including ineligibility for incentives due to an alleged Health Insurance Portability and Accountability Act (HIPAA) violation; and patient compliance with specified measures.

The groups sent Dr. Blumenthal recommendations [ PDF ] for defining meaningful use of EMRs. They include guiding key principles for achieving widespread adoption of EMRs and other health information technology (HIT) and ensuring patient access to quality and timely care. They also establish a pathway toward meaningful use, including a set of program specifications for meeting the 2011 incentive payment time frame and beyond.

TMA encourages physicians to proceed with caution and tap into the association's resources to make wise decisions regarding EMR selection and implementation. For more information, visit the new TMA Federal Stimulus Package Resource Center .